scholarly journals Prenatal sFlt-1/PlGF value for prediction of adverse neonatal outcome of isolated ultrasonic small-for-gestational-age fetus in normotensive pregnant women: A prospective cohort study

2019 ◽  
Author(s):  
So Hyun Shim ◽  
Haeng Jun Jeon ◽  
Hye Jin Ryu ◽  
So Hyun Kim ◽  
Seung Gi Min ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Neonatal Outcome ◽  
Adverse Outcome ◽  
Control Group ◽  
Third Trimester ◽  
Cutoff Value ◽  
Adverse Neonatal Outcome ◽  
Increased Risk ◽  
Plgf Ratio

Abstract Background Not only preeclampsia but also small-for-gestational-age (SGA) neonates in the absence of preeclampsia are at increased risk of morbidity and mortality. Early recognition of fetuses at increased risk of being growth-restricted enables more appropriate surveillance and optimization of management for reduced risk of adverse neonatal outcomes. We investigated potential value of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio, estimated in late-second and early-third trimester respectively, for prediction of SGA neonates with poor neonatal outcome. Methods Included in this case control study were 530 singleton pregnant women who had attended the prenatal screening program at single institution between January 2011 and March 2012. The maternal serum levels of sFlt-1 and PlGF at 24 to 28+6weeks and 29 to 36+6weeks of gestation were measured for comparing control and SGA group. Results After excluding 22 preeclampsia cases, 47 SGA group and 461 control-group were included. Mean gestational age at delivery in SGA group was 37.76 ± 2.05weeks, which showed no significant difference comparing to control group (38.43 ± 2.1weeks, p=0.122). The sFlt-1/PlGF ratios at late-second trimester and early-third trimester were both higher in the SGA group than control group (7.62 vs 3.74, p=0.63; 28.62 vs 14.42, p=0.037) and especially sFlt-1/PlGF ratio at early-third trimester was significantly higher in the SGA group. Among SGA group, 17 neonates had adverse neonatal outcome (36.1%, 17/47). Both sFlt-1/PlGF ratios in each trimester were also higher in poor SGA group than control group (6.73 vs 3.77, p = 0.379; 109.12 vs 15.27, p=0.002). As gestational age advances, rapid increase in sflt-1/PlGF ratio detected in poor SGA group comparing to SGA group with no adverse outcome. A cutoff value of 28.15 for the sFlt-1/PlGF ratio at 29 to 36+6weeks significantly predicted SGA neonates who had adverse outcome, with sensitivity and specificity of 76.9% and 88%, respectively. Conclusion In this study, sFlt-1/PlGF ratio of SGA with adverse neonatal outcome group was significantly higher than control group. This study suggests the feasibility of the sFlt-1/PlGF ratio as helpful objective measurement for predicting the adverse SGA neonatal outcome by providing sFlt-1/PlGF cutoff value, besides ultrasound biometry measurement.

scholarly journals Prenatal sFlt-1/PlGF value for prediction of adverse neonatal outcome of isolated ultrasonic small-for-gestational-age fetus in normotensive pregnant women: A prospective cohort study

2019 ◽  
Author(s):  
So Hyun Shim ◽  
Haeng Jun Jeon ◽  
Hye Jin Ryu ◽  
So Hyun Kim ◽  
Seung Gi Min ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Neonatal Outcome ◽  
Adverse Outcome ◽  
Control Group ◽  
Third Trimester ◽  
Cutoff Value ◽  
Adverse Neonatal Outcome ◽  
Increased Risk ◽  
Plgf Ratio

Abstract Background: Not only preeclampsia but also small-for-gestational-age (SGA) neonates in the absence of preeclampsia are at increased risk of morbidity and mortality. Early recognition of fetuses at increased risk of being growth-restricted enables more appropriate surveillance and optimization of management for reduced risk of adverse neonatal outcomes. We investigated potential value of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio, estimated in late-second and early-third trimester respectively, for prediction of SGA neonates with poor neonatal outcome in the absence of preeclampsia. Methods: Included in this case control study were 530 singleton pregnant women who had attended the prenatal screening program at single institution between January 2011 and March 2012. Demographic and clinical information of maternal and neonatal data were collected. The sFlt-1/ PlGF value at 24 to 28+6 weeks and 29 to 36+6 weeks of gestation were analyzed for comparing appropriate for gestational age control group, SGA and SGA with poor neonatal group. Results: After excluding 22 preeclampsia cases, 47 SGA group and 461 control-group were included. Among SGA group, 17 neonates had adverse neonatal outcome (36.1%, 17/47). Mean gestational age at delivery in SGA group was 37.76±2.05 weeks, which showed no significant difference comparing to control group (38.43±2.1 weeks, p=0.122). The sFlt-1/PlGF ratios at late-second trimester were both higher in the SGA group and poor neonatal SGA group than control group (3.74±2.52 vs 6.73±8.22 vs 7.62±15.2, p=0.63) and especially sFlt-1/PlGF ratio at early-third trimester was significantly higher (14.41±12.5 vs 28.62±37.2 vs 109.12±83.96, p=0.002). As gestational age advances, rapid increase in sflt-1/PlGF ratio detected in poor SGA group comparing to SGA group with no adverse outcome. A cutoff value of 28.15 for the sFlt-1/PlGF ratio at 29 to 36+6weeks significantly predicted SGA neonates who had adverse outcome, with sensitivity and specificity of 76.9% and 88%, respectively. Conclusion: In this study, sFlt-1/PlGF ratio of SGA with adverse neonatal outcome group was significantly higher than control group. This study suggests the feasibility of the sFlt-1/PlGF ratio as helpful objective measurement for predicting the adverse SGA neonatal outcome by providing sFlt-1/PlGF cutoff value, besides ultrasound biometry measurement.

scholarly journals Correlation study between increased fetal movement during the third trimester and neonatal outcome

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cuiqin Huang ◽  
Wei Han ◽  
Yajing Fan
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Gestational Age ◽  
Neonatal Outcome ◽  
Stress Test ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Third Trimester ◽  
The Third ◽  
Fetal Movements

Abstract Background We aimed to analyze the correlation between increased fetal movements in the third trimester and neonatal outcomes. Methods We enrolled pregnant women (n = 219) who reported increased/excessive fetal movements in the third trimester in our hospital. A control group of healthy women (n = 278) who had undergone regular childbirth and delivery in our hospital during the same period and did not report abnormal fetal movements were also recruited. All pregnant women underwent fetal non-stress test. We analyzed the neonatal weight, appearance, pulse, grimace, activity, and respiration score, degrees of amniotic fluid contamination, amniotic fluid volume, conditions of umbilical cord around the neck and cord length, and incidence of small for gestational age. In addition, the incidence of preterm delivery, cesarean section rate, postpartum hemorrhage, and other postpartum complications were also analyzed. We then analyzed the correlation between increased/excessive fetal activity and neonatal outcomes. Results Women with complaints of increased/excessive fetal movements exhibited increased fetal movements mainly around 31 and 39 weeks of gestation. Several pregnancy variables, including number of previous delivery, gestational age (less than 34 weeks and more than 37 weeks) and vaginal birth rate, were associated with increased/excessive fetal movements. In addition, women who reported increased/excessive fetal movements had higher odds of large for gestational age (LGA), particularly those with gestational age over 37 weeks. Conclusion Increased/excessive fetal movements may be used to predict adverse neonatal outcome such as LGA.

scholarly journals Can Fetal Growth Velocity and First Trimester Maternal Biomarkers Improve the Prediction of Small-for-Gestational Age and Adverse Neonatal Outcome?

2019 ◽  
Vol 46 (4) ◽  
pp. 274-284 ◽  
Author(s):  
Manouk L.E. Hendrix ◽  
Judith A.P. Bons ◽  
Roy R.G. Snellings ◽  
Otto Bekers ◽  
Sander M.J. van Kuijk ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Growth Velocity ◽  
Neonatal Outcome ◽  
First Trimester ◽  
Adverse Neonatal Outcome

scholarly journals Marcadores Bioquímicos do Primeiro Trimestre e Recém-Nascidos Leves para Idade Gestacional

2014 ◽  
Vol 27 (2) ◽  
pp. 191
Author(s):  
Cláudia Andrade ◽  
Joana Santos ◽  
Ana Rita Pinto ◽  
Pedro Manso ◽  
Susana Pereira
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Odds Ratio ◽  
Biochemical Markers ◽  
First Trimester ◽  
Control Group ◽  
Maternal Weight ◽  
Increased Risk ◽  
Β Hcg

<strong>Introduction:</strong> Several studies suggested an association between first trimester biochemical markers (PAPP-A and β- HCG) and infants below 10th percentile. Our goal was to describe this relationship of biochemical markers with small-for- gestational-age fetuses in our population.<br /><strong>Material and Methods:</strong> Retrospective analytic study of 2 035 pregnant women that underwent first-trimester screening in the period between March 2009 and September 2011. Small-for-gestational-age infants below 10th percentile were compared with control group (term newborn with birth weight above 10th percentile). Infants below 3rd percentile and control group were also compared. Multiple and logistic regression analysis were done with PAPP-A, β-HCG (multiples of the expected normal median) and demographic maternal characteristics (ethnicity, weight and smoker status).<br /><strong>Results:</strong> This study demonstrated an independent contribution of PAPP-A, maternal weight and smoker status in predicting small-for-gestational-age infants. For PAPP-A, the odds ratio for small-for-gestational age below 10th and 3rd percentile was 2.41 and 3.41, respectively (p &lt; 0.01). For β-HCG, odds ratio below 10th percentile was 1.70 (p = 0.03) and for birth weight below the 3rd percentile, the odds ratio was 3.22 (p &lt; 0.01).<br /><strong>Conclusions:</strong> Low levels of PAPP-A and β-HCG (values below 5th percentile of the study population) were associated with an increased risk of small-for-gestational-age infants in the pregnant population included in this study.

scholarly journals sFlt-1/PlGF Ratio in Prediction of Short-Term Neonatal Outcome of Small for Gestational Age Neonates

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 718
Author(s):  
Jacek Witwicki ◽  
Katarzyna Chaberek ◽  
Natalia Szymecka-Samaha ◽  
Adam Krysiak ◽  
Paweł Pietruski ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Neonatal Outcome ◽  
Perinatal Outcomes ◽  
High Ratio ◽  
Short Term ◽  
Adverse Perinatal Outcomes ◽  
Lower Birthweight ◽  
Plgf Ratio ◽  
Normotensive Pregnancy

Background: Small for gestational age is a pregnancy complication associated with a variety of adverse perinatal outcomes. The aim of the study was to investigate if sFlt-1/PlGF ratio is related to adverse short-term neonatal outcome in neonates small for gestational age in normotensive pregnancy. Methods: A prospective observational study was conducted. Serum sFlt-1/PlGF ratio was measured in women in singleton gestation diagnosed with fetus small for gestational age. Short-term neonatal outcome analyzed in the period between birth and discharge home. Results: Eighty-two women were included. Women with sFlt-1/PlGF ratio ≥33 gave birth to neonates with lower birthweight at lower gestational age. Neonates from high ratio group suffered from respiratory disorders and NEC significantly more often. They were hospitalized at NICU more often and were discharged home significantly later. sFlt-1/PlGF ratio predicted combined neonatal outcome with sensitivity of 73% and specificity of 82.2%. Conclusions: sFlt-1/PlGF ratio is a useful toll in prediction of short-term adverse neonatal outcome in SGA pregnancies.

scholarly journals Is the Cerebro-Placental Ratio Sufficient to Predict Adverse Neonatal Outcome in Small for Gestational Age Fetuses > 34 Weeks of Gestation?

2021 ◽  
Vol 2 (1) ◽  
pp. 2-11
Author(s):  
Jarmila A. Zdanowicz ◽  
Muriel Disler ◽  
Roland Gerull ◽  
Luigi Raio ◽  
Daniel Surbek
Keyword(s):  
Gestational Age ◽  
Neonatal Outcome ◽  
Area Under The Curve ◽  
Fetal Outcome ◽  
Predictive Capability ◽  
Cutoff Value ◽  
Additional Tool ◽  
Adverse Neonatal Outcome ◽  
Academic Center ◽  
Adverse Fetal Outcome

Fetuses with an estimated weight (EFW) below the 10th percentile are at risk for adverse perinatal outcome and clinical management remains a challenge. We examined EFW and cerebro-placental ratio (CPR) with regard to their predictive capability in the management and outcome of such cases. Fetuses were first diagnosed as small after 34 weeks of gestation with an actual EFW below the 10th percentile at our tertiary academic center. We determined the optimum cutoff value for CPR and EFW in predicting adverse neonatal outcome. Mean gestational age at diagnosis was 36 weeks. One hundred and two cases were included in our study. We determined a CPR of 1.4 and an EFW of 2152 g to be the best cutoff value for predicting adverse fetal outcome, with an area under the curve (AUC) of 0.65 (95% CI 0.54–0.76); p = 0.009, and 0.76 (95% CI 0.66–0.86); p < 0.0001, respectively. However, when comparing EFW with CPR, EFW seems to be slightly better in predicting adverse fetal outcome in our group. While the use of CPR alone for the management of small fetuses is not sufficient, it is an important additional tool that may be of value in the clinical setting.

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